Dermatology

Many patients with leprosy come to its hospitals thinking they have a skin disease. In the hospital, they are diagnosed with leprosy. Conversely, many with skin diseases come to its hospitals to confirm that they do not have leprosy.

In 2022, we had 84791 dermatology consultations in our hospital. Diseases usually diagnosed are infective (fungal, bacterial or viral), autoimmune diseases (such as psoriasis or pemphigous), and disorders of pigmentation (such as vitiligo), many of which could mimic leprosy.

Vitiligo
Patient consulting a DermatologistVitiligo or leukoderma is a benign skin disease that causes depigmentation. Apart from the obvious cosmetic challenge it poses, the fact that it is still widely confused with leprosy makes it the commonest presenting complaint in our dermatological OPD.

Dermatitis
These are a group of skin disorders with protean manifestations. All ages of people present all year round with a spectrum of allergic dermatitis. Topical steroids remain the mainstay of treatment.

Acne
Most adolescents suffer from this common skin condition in varying degrees of severity. This is a common side effect of chronic steroid therapy for leprosy conversion reactions.

Fungal infection
Fungal infection/tinea can affect any area of the body, including the scalp and the nails. Seasonal flares are common. They respond well to weekly oral antifungals.

Pemphigus
It is a skin disease characterised by severe bullous eruptions and systemic compromise ranging from mild to life-threatening. The disease course is long, with exacerbations and remissions.

Psoriasis
It is an autoimmune skin disease presenting with skin lesions in varying morphological forms and severity. Winter exacerbations are characteristic.

Skin TB and other skin diseases
Skin TB requires biopsy confirmation before Anti TB treatment can be started.

Various other skin conditions, particularly the mimickers of Hansen’s present to the OPD, need to be subject to a thorough clinical examination and skin smears.